Female hormone therapy treating early menopause can also preserve cancer patients’ fertility

Hormone therapy is often thought of as a treatment to relieve symptoms in menopausal women, but its use has been expanded in recent years.

Experts note that female hormones play an important role in women's lives, including menstruation, pregnancy, lactation, bone density, and cardiovascular health.

In a recent news release, Dr. Ku Seung-yup, a professor of obstetrics and gynecology at Seoul National University Hospital, discussed the treatment areas and precautions for female hormone therapy, which is important for maintaining a harmonious balance through delicate regulation.

Female hormone therapy is mainly practiced in obstetrics and gynecology to balance female hormones, such as estrogen and progesterone.

It is effective in managing menopausal symptoms, treating infertility, and improving menstrual irregularities by supplementing deficient hormones or suppressing excessive hormone secretion. It is also used for contraception. Depending on the purpose of the treatment, female hormone therapy can be administered in different ways, including pills, topicals, vaginal tablets, injections, or patches.

As women age, they lose estrogen. As a result, nine out of 10 postmenopausal women suffer from menopausal symptoms, including hot flashes, night sweats, and sleep disturbances. Vaginal dryness and cystitis are also common.

Hormone replacement therapy, which replenishes female hormones, not only relieves these symptoms but also helps prevent osteoporosis. This is especially important for women who have undergone early menopause before the age of 40, as they are more prone to rapid aging and health problems.

Female hormone therapy is also used to treat endometriosis. Endometriosis is the growth of endometrial tissue that attaches to the pelvic cavity and other areas outside the uterus. If it grows large enough, it can become cancerous. Endometriosis is common, affecting about one in 10 women and three to five in 10 women with infertility. It's also not uncommon for women to be diagnosed by accident when they visit their doctor with sudden menstrual pain.

In the past, endometriosis was treated primarily through surgery, but in recent years, with the development of progestins (synthetic progesterone drugs), hormone therapy has become a popular treatment option.

Female hormone therapy is also used to preserve fertility. In recent years, hormone therapy has been used in various ways, as infertility problems and the long-term survival of cancer patients in the era of low birthrate have emerged.

For female cancer patients of childbearing age, hormone therapy plays an important role in preserving the possibility of pregnancy and childbirth. For example, women diagnosed with breast cancer used to be concerned that they would have to give up pregnancy while undergoing chemotherapy and anti-hormonal treatment to prevent recurrence. In recent years, however, women can actively consider fertility preservation through egg freezing for single women and embryo transfer for married women.

In this case, female sex hormones are used to induce hyperovulation, and hormonal agents that suppress the abnormal rise of female sex hormones, including letrozole, can be combined to increase the safety of the egg-to-embryo transfer process.

In rare cases, women with early-stage endometrial cancer have given birth to healthy babies via IVF after successful chemotherapy hormone treatment instead of hysterectomy. Therefore, if you are diagnosed with cancer at a young age, it's a good idea to talk to your doctor about your pregnancy and childbirth plans before starting treatment.

Estrogen monotherapy can cause endometrial cancer, so patients should also use progesterone

Female hormone therapy shouldn’t be taken lightly. This is because there’s a high risk of harm if done incorrectly.

Estrogen monotherapy can promote the growth of the uterine lining, which can lead to problems like endometrial cancer. To prevent this, the correct dose and type of progesterone should be combined with estrogen.

“Hormone therapy can cause serious side effects, such as irregular bleeding and thrombosis, even in very small doses, so it can be dangerous to take hormones as if they were dietary supplements or functional products like vitamins,” Professor Ku said.

For those who continue hormone therapy, it is necessary to conduct regular breast, ovarian, and uterine exams and blood tests about once a year to keep cancer at bay.

If you are experiencing women's health problems, such as amenorrhea, endometriosis, or menopausal symptoms, you should consult a gynecologist, preferably a doctor who specializes in gynecologic endocrinology, to develop and monitor a hormone treatment plan that is optimized for your situation,” Professor Ku said. “Above all, a good lifestyle plays an important role in maintaining hormonal balance, so eating a healthy diet and exercising regularly will help you achieve a better quality of life.”